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President Barack Obama delivers remarks during a meeting with people that wrote him letters explaining how they benefited from the Affordable Care Act in the Roosevelt Room of the White House, on Tuesday. Dallasite Tonya Fisher is seated directly across the president. Obama also condemned the execution of Jordanian Air Force pilot First Lt. Moaz al-Kasasbeh by the Islamic State group.

Update 4:40pm

WASHINGTON – The House has voted along party lines to repeal Obamacare, though three Republicans sided with Democrats. It’s the fourth time the GOP-run House has voted explicitly to scrap the law, though the chamber has voted more than 50 times to defund or chip away at it in the last three years.

Earlier, meeting with Dallasite Tonya Fisher and nine other beneficiaries of his signature health care overhaul. President Obama derided the relentless efforts to undo a law that has expanded coverage to some 10 million Americans.

“The House of Representatives has scheduled yet another vote today to take health care away from the folks sitting around this table. I don’t know if it’s the 55th or the 60th time,” he said. “… Why is it that this would be at the top of their agenda—making sure that people who don’t have health care aren’t able to get it?”

Fisher was seated directly across from the president in the Roosevelt Room, an ornate meeting space near the Oval Office.

She was flanked by Derrick Benn of San Francisco, and Regina Moran. Moran, a Philadelphia social worker first diagnosed with cancer at age 12, credits the ACA with drastically cutting her medication costs. Benn, who tutors high school students in math, chemistry and physics, couldn’t afford insurance; he qualified for Medicaid and now has better access to diabetes treatment.

“Everybody here has directly benefited from the Affordable Care Act,” Obama said. “Tonya, shortly after signing up for the ACA in a checkup, was diagnosed with a brain tumor, would not have even discovered it had it not been for the Affordable Care Act.”

Fisher, a middle school teacher at a charter school in Oak Cliff, A.W. Brown Fellowship – Leadership Academy, said afterward that Obama showed he had a “huge heart” by spending time with her and the others, and defending the law.

“I don’t know that he’s interested in shaming the Republicans as much as he’s interested in letting millions of Americans who are uninsured to know how important it is for them to get coverage,” she said. As for the fact that Republicans remain committed to undoing the law, she said, “It saddens me. Because what they are in effect doing is dissuading millions of Americans from getting the help they need. It’s a shame. A shame.”

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WASHINGTON – As the GOP-run House prepares to vote today, yet again, to repeal Obamacare, the president will meet with 10 Americans who became insured under the program – including a Dallas woman afflicted with a brain tumor.

Tonya Fisher wrote President Obama last May to thank him for the Affordable Care Act and its unexpected impact on her life. In November 2013, the right side of her face went numb. She visited a dentist, endodontist, oral surgeon and neurologist seeking answers.

She was unemployed and uninsured.

At her mother’s urging, Fisher enrolled for health coverage through the insurance marketplace set up by the federal government after Texas officials refused to set up a state exchange.

staff/Todd J. Gillman

Dallas resident Tonya Fisher wrote President Obama to thank him for Obamacare, after being diagnosed with a brain tumor. She spoke with reporters Tuesday Feb. 3, 2015, after meeting with Obama in the Roosevelt Room of the White House.

That coverage kicked in on Jan. 1, 2014. Twenty days later, a neurologist diagnosed a brain tumor.

“There are many things you never want to hear, and this was certainly one of them. But the bright light, Mr. President, was that I was insured. I had a long and painful road ahead of me, but I did not have to put my family into debt on the way,” she wrote the president.

Such stories, Obama aides said, show the law works and deserves protection. The law has allowed 10 million people to get health insurance coverage, pushing the uninsured rate near an all-time low, and it protects patients from losing coverage for pre-existing conditions. But Republicans call it costly, a huge drag on the economy, and an overreach by the federal government. Later today, House leaders have scheduled a vote to scrap the law, and to direct relevant congressional committees to craft an alternative for keeping Americans insured.

“Congress has tried to repeal or undermine this law more than 50 times, but the President will continue to stand with the families who have better care and choices as a result of the law,” a White House aide said. “The individuals meeting with the President today highlight how important it is to spread the word and ensure that all Americans have the opportunity to sign up for the health care they need.”

AP Photo/J. Scott Applewhite

Rep. Michael C. Burgess, R-Lewisville, displays his tattered working copy of the Affordable Care Act at a House Rules Committee meeting on Monday, ahead of a vote to repeal the law scheduled for Tuesday.

The president would veto any repeal legislation that reaches his desk. But that isn’t the only threat to the Affordable Care Act.

On March 4, the Supreme Court will hear arguments in a major challenge to the law. The case, King v. Burwell, hinges on the issue of whether subsidies are available for anyone in every state, or only in those states that run their own health insurance exchange.

Texas refused to set up an exchange, making it one of 37 states where the federal government stepped in to provide coverage options. If the court rules against the administration, 5 million Americans could lose subsidized coverage, presumably including Fisher.

Texas has more uninsured residents than any other state. The White House provided statistics meant to underscore the success of Obamacare:

Statewide in Texas, in 2014 the average premium after tax credits for the most popular type of plan was $68 per month. Nearly 85 percent of consumers got tax credits.

As of a week ago, 940,000 people in Texas had selected a plan or been reenrolled in coverage through the Health Insurance Marketplace.

The number of choices available to Texans averaged 31 plans in the Marketplace, up from 25 in 2014.

Resistance from Gov. Greg Abbott and his predecessor, Rick Perry, limited the impact. In California, by contrast, 1.2 million people had coverage through the marketplace, and another 2.6 million got coverage under Medicaid and the Children’s Health Insurance Program

Deputy Comptroller Billy Hamilton, foreground, listens to a question during a news conference held by Texas Comptroller Carole Keeton Strayhorn, right, on a new internet tool for businesses to calculate their taxes.

Gov.-elect Greg Abbott has enlisted two state government veterans to quickly review contracting practices and oversight in Medicaid and social services programs.

In recent weeks, press reports and state Auditor John Keel have raised troubling questions about two major contracts — a $20 million award to Austin tech company 21CT to detect Medicaid fraud and a $105 million, telecom “managed services” deal with Dallas-based AT&T Inc.

The telecom deal was evaluated and partly managed by state employees who previously worked for AT&T, according to a critical state audit released last month. According to earlier press reports, a former lobbyist for 21CT used to be a business partner of Jack Stick — at the time, a high-ranking Health and Human Services Commission official.

Ashley Landis/The Dallas Morning News

Gov.-elect Greg Abbott applauds while listening to Speaker Joe Straus on opening day in the House Tuesday.

Abbott, who will be sworn in on Tuesday, said he’s asked Hamilton to lead “a full and thorough outside review” of the commission’s operations. He said he coordinated the appointments of Hamilton and Peterson with commission chief Kyle Janek.

Hamilton currently serves as executive vice chancellor and chief financial officer of the Texas A&M University System. A decade ago, he led a blue-ribbon review of California state agencies for then-Gov. Arnold Schwarzenegger. Peterson has been at the agriculture agency since 2008. She previously held budget and financial analyst posts at the state health department and in city governments in Boston and Austin.

The Sunset Advisory Commission, which checks out the efficiency of state agencies, has proposed extensive changes to procurement in Medicaid and social services and an overhaul of the Medicaid-fraud “police,” the Office of Inspector General at Janek’s sprawling agency. Sunset chairwoman and Sen. Jane Nelson, a Flower Mound Republican who is the Senate’s top budget writer, has said she plans this session to add new contracting provisions to a “sunset bill,” the measure needed to extend the Health and Human Services Commission’s life.

Janek said he’s cooperating fully.

“We recognize the need for the structural changes that Sunset recommended, and we’ve identified others on our own,” he said in a statement. “We appreciate the help the governor-elect is sending.”

The agency that periodically looks at whether state agencies are efficient has urged that five existing social services agencies be merged into one.

The consolidation would reduce fragmentation in programs such as Medicaid and women’s health, help the five departments better manage their $24 billion of contracts and finish a streamlining effort the Legislature began in 2003, said a report released Friday by the Sunset Advisory Commission.

A 15-year-old pilot program for mental health services delivery in the Dallas area, NorthSTAR, is “outdated” and should be blended into a statewide model, the commission’s staff report also recommended.

“The state did not finish the job,” the report said of a 2003 law that reduced Texas’ health and human services system from 12 agencies to five.

One of them, the Health and Human Services Commission, oversees the rest and administers most of the state-federal Medicaid program for the poor.

Its leader, former state Sen. Kyle Janek, did not specifically comment on the sunset group’s recommendations.

In a written statement, Janek said he’s pushing the four department chiefs under him “to look for ways we can simplify things behind the scenes so it’s easier for people to get the help they need, no matter which of our agencies they turn to first.”

Brad Loper/Staff photographer

Rep. Garnet Coleman, center, at a 2013 mental health forum in Dallas

Janek said the state’s sprawling health and welfare bureaucracy will “be ready to quickly put in place” whatever changes lawmakers approve next year “to improve our programs and ensure we operate as efficiently as possible.”

A veteran House social services policy writer, though, disputed the report’s recommendation of further consolidation.

Rep. Garnet Coleman, D-Houston, noted that smaller agencies, overseen by independent boards appointed by the governor, were used until the early 2000s.

The arrangement worked better than the current system, under which Janek and the four other department heads are named by and answer directly to Gov. Rick Perry, Coleman said.

“Moving the deck chairs around doesn’t solve the customer service problem and it also consolidates more power under one person, the governor,” he said. “So it lends itself to more political decisions.”

The report said the existing set up suffers from problems such as “blurred accountability,” duplicated administrative support staffs and unnecessary expenses.

“Fragmented programs result in divided policy direction and weakened administrative oversight,” it said.

Instead of unwinding the 2003 consolidation, though, the report urged lawmakers to create one big commission “with divisions established along functional lines.” Such a merger “clarifies lines of authority [and] helps to reduce the silo mentality that the five-agency system reinforces,” it said.

The report criticized NorthSTAR as standing apart from society’s ongoing push to integrate mental and physical health services. It said the pilot “continues to exist as an island with the state,” and is unable to tap into federal funds provided under Texas’ Medicaid “transformation waiver.”

Coleman, though, said NorthSTAR has avoided mistakes state officials imposed on the rest of the state in the past decade, such as trying to limit state help to people diagnosed with schizophrenia, bipolar disease and major, treatment-resistant depression. NorthSTAR used a managed care model and helped all comers, he said.

“They’ve been able to serve more people and it works,” he said. “Consumers, mental health advocates, everybody I’ve talked to loves NorthSTAR.”

The sunset commission, a 12-member group comprised of five senators, five state representatives and two public members, will meet next month to take up the staff’s recommendations.

WASHINGTON –The number of uninsured patients treated at hospitals dropped sharply this year, top White House officials said Wednesday – cutting costs dramatically for states that opted to expand Medicaid.

Texas isn’t one of those states.

Under Gov. Rick Perry, it has firmly refused to expand the program aimed at providing health coverage to low-income Americans. The Obama administration calls that a costly mistake, with a new study of uncompensated costs providing the latest evidence that Texas hospitals and taxpayers pay a steep price.

A report released today by the Department of Health and Human Services projects that hospitals nationwide will save $5.7 billion this year in uncompensated care costs because of the Affordable Care Act.

States that have expanded Medicaid enjoyed three-fourths of that. Texas and the rest collected only a quarter of the benefits, about $1.2 billion.

“Many of the hospitals in these communities feel it already,” HHS Secretary Sylvia Burwell told a roomful of reporters at a White House briefing. “The data and information will help them make their case more strongly with regard to the importance to their bottom line of the expansion of Medicaid.”

The Texas Hospital Association estimates that hospitals in the state provide $5.5 billion annually in uncompensated care.

Lance Lunsford, the association’s vice president of advocacy communications, asserted that many states that expanded Medicaid themselves have missed opportunities to cut costs.

“Texas still has to provide unique private market coverage options that stimulate personal responsibility through HSAs [health savings accounts] and co-pays and perhaps incentivizing primary care access instead of the ER,” he said.

The report Burwell unveiled today is part of an ongoing effort to pressure and persuade Texas and 22 other holdouts to expand Medicaid coverage.

“Medicaid is a broken system – a fact even President Obama has acknowledged – and Texas already spends 25% of our budget on Medicaid services. Expanding this struggling program would cost Texas taxpayers nearly $9 billion over ten years, and would pull state tax dollars from other essential areas like education, public safety and infrastructure. The governor continues to believe in flexibility for the states to operate their Medicaid programs in a way that most benefits their citizens,” she said.

At the Center for Public Policy Priorities, an Austin-based group that advocates for low-income Texans, associate director Anne Dunkelberg noted that a flurry of recent reports from around the country shows the same thing: States that expanded Medicaid have seen a dip in uncompensated costs, while costs have not dropped, or haven’t dropped nearly as much, in states that refuse to expand Medicaid.

“The states that haven’t addressed their coverage gap haven’t moved,” she said.

These costs are relatively heavy in Texas, with its high percentage of uninsured working poor – people whose earnings are too high to qualify them for Medicaid but still below the poverty line, and too low to qualify for subsidized insurance under the Affordable Care Act.

When these folks end up at a hospital, they don’t pay out of pocket. There’s no insurer. Local property taxes are used to cover the costs.

“It’s all picked up by the taxpayer,” Dunkelberg said.

Burwell noted that Pennsylvania, with a Republican governor, agreed last month to expand Medicaid. And there’s talk of expansion in other GOP-run states, including Wyoming and Utah.

“People are influenced by people who are like them,” she said. “The more that we are able to attract conservative Republican governors, the more that those who have very strong feelings will, perhaps, listen. They all talk to each other, all the governors, whether it’s about… unaccompanied children, Ebola or Medicaid.”

The president’s Council of Economic Advisers issued a report in July detailing the costs of not expanding Medicaid.

Jason Furman, chairman of the council, said Wednesday that states that have refused to expand Medicaid leave “tens of billions” in savings on the table for the rest to divvy up.

Under the Affordable Care Act, states can expand Medicaid coverage to people with incomes 1/3 higher than the poverty level (about $31,322 for a family of four). Twenty-seven states have done so. As of July, nearly 8 million more people were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) than were enrolled last October, when open enrollment began.

Texas could collect $100 billion in federal funds over 10 years if it agreed to expand Medicaid eligibility.

Perry and other state leaders refuse, saying the state would have to spend too much of its own revenue and shouldn’t do so to expand a flawed system.

Texas Medicaid officials, already in a legal battle with Xerox Corp. over the company’s alleged failure to prevent widespread dental fraud, filed another lawsuit Tuesday accusing Xerox of improperly taking large quantities of medical records and not protecting patients’ confidentiality.

The state Health and Human Services Commission said it filed a lawsuit in state district court in Austin seeking return of the patient data.

The commission said it also has filed a notice with federal officials that Xerox “is now out of compliance” with privacy rules under the 1996 federal Health Insurance Portability and Accountability Act.

“Once again, the reckless and irresponsible actions of this company put Texas tax dollars at risk,” Kyle Janek, the state agency’s executive commissioner, said in a statement. “It really makes you wonder what they’re trying to hide.”

Xerox spokesman Kevin Lightfoot, though, said in an email that “the data represents proprietary Xerox information and was retained with the state’s knowledge.”

He said state officials have “declined repeated opportunities to review the material.” Lightfoot said a court hearing will be held on the matter next month.

The dispute stems from state allegations that Xerox failed in its duty as the state’s Medicaid claims administrator to stand guard and make sure dentists who wanted to put braces on poor children complied with state Medicaid laws and rules that bar doing such work for cosmetic reasons.

Xerox has denied the state’s claims, calling them “misdirected” and an attempt to blame the Connecticut-based company instead of “the dentists who took advantage of the program.”

Medicaid is the state-federal health insurance program for the poor, elderly and disabled. In response to a long-running class action complaint known as the Frew lawsuit, Texas agreed in 2007 to improve preventive dental care for poor children by luring dentists back into the program and making greater efforts to ensure that kids have regular checkups. Under normal circumstances, the increased volume would increase demand for orthodontic work.

However, commission officials have said Dallas-based Affiliated Computer Services, which Xerox bought in 2010, fell down on the job of requiring proper “prior authorization” consents for expensive braces.

The state has said that ACS, though supposed to approve putting braces on children only when misalignment of teeth makes it difficult for a child to breathe or eat, had only lax controls and essentially rubber-stamped dentists’ prior authorization requests.

Texas Medicaid’s spending on orthodontic work more than tripled, from $67 million in fiscal 2006 to $228.9 million five years later.

In May, Texas sued Xerox for non-performance and demanded recovery of the misspent money. The commission cancelled Xerox’s five-year, $759 million claims administration contract about three years early.

At the time, Xerox said it would “defend itself vigorously.”

On Tuesday, company spokesman Lightfoot emailed a reporter a July 21 court filing that described a tussle over 2 million pages and more than a terrabyte of patient data. Xerox lawyers have asked a state district court in Travis County to protect what they called “attorney work product.” In their motion, the company’s lawyers said the state has rejected Xerox’s proposals for guaranteeing patient privacy and is making unreasonable demands.

Janek, though, said Xerox has overstepped its bounds.

“There is a legal process for the company to get any records it needs for the lawsuit, but instead Xerox has chosen to put information of Medicaid clients at risk and force the state to take court action to protect those records,” he said.

Janek said Xerox acknowledged in a July 21 court filing that it removed files from servers and hard drives and allowed lawyers and another company to see the records. Janek said the commission learned that Xerox “removed 244 boxes of information” before handing off the claims administration work to Accenture earlier this month. The commission believes the files include client names, photographs, birth dates and medical and billing records, Janek said.

“We don’t know anything about the security of the servers now housing the information, staff training, background checks, nothing,” he said.

However, Xerox insisted it needs the records to defend itself. Its July motion said that the state, while suing Xerox for more than $1 billion, “demands that Xerox return or destroy the documents that Xerox collected in compliance with the state’s investigative demands — at great expense to Xerox.” It referred to a June 2012 civil investigative demand made of it by Attorney General Greg Abbott’s office.

With full knowledge by the state, Xerox said it “has had, for the past two years, full and unfettered access” to the records the state now is demanding, according to the motion filed by the company’s lawyers with Gibson, Dunn & Crutcher in Dallas and the Beck Redden LLP law firm in Austin. In current circumstances, however, Xerox lawyers Robert Walters and Eric Nichols said the computers and electronic storage devices contain “privileged communications and attorney work product.”

The House on Sunday night accepted Sen. Jane Nelson’s and other lawmakers’ clean up of an amendment by a freshman state representative from Collin County that would require a rubber stamp from the Legislature before Medicaid could be expanded to cover more able-bodied adults.

Basically, they feared Rep. Jeff Leach’s provision could screw up two things — some shifts of the state’s most disabled individuals between so-called “Medicaid waiver programs,” as the bill attempts to improve and shrink the cost of their long-term care services; and the scheduled addition to Medicaid of foster children through age 26 and a subset of youngsters now on the Children’s Health Insurance Program. Under the federal health care law, some current CHIP recipients — those ages six through 18 and just over the poverty line — will have to be shifted to Medicaid. That and the extension of coverage for former foster children are noncontroversial requirements of the federal health care law.

The long term care bill, which would expand use of managed care in Medicaid, received final House approval and was finally sent to the governor. The vote was 146-1.

Last week, Leach, R-Plano, added the provision to the measure by Nelson, R-Flower Mound. Effectively, it would have barred the Texas Health and Human Services Commission from accepting anyone into Medicaid who was not eligible under this year’s rules as of Dec. 31. Leach said he wanted to make sure lawmakers, not just Gov. Rick Perry, have a say on whether Texas expands Medicaid to cover uninsured adults of working age. Texas currently covers almost none.

Rep. Richard Raymond, a Laredo Democrat who was House sponsor of Nelson’s bill, said the new language added by House-Senate negotiators makes sure Leach’s amendment does no collateral damage.

Rep. Giovanni Capriglione, R-Southlake (left), speaks with Rep. Steve Toth, R-The Woodlands (right), and another state rep on the Texas House floor in late April.

The House on Thursday afternoon rejected an attempt to put an exclamation point on members’ recent demand that the Legislature be involved in any decision to expand Medicaid in Texas.

The House defeated a motion by Rep. Giovanni Capriglione, R-Southlake, to instruct House-Senate negotiators to keep language the House added Monday night to an unrelated Medicaid bill. The new language effectively would require the Legislature to approve any enlargement of Medicaid. The vote against the motion to instruct was 71-68. Seventeen Republicans joined 54 of the chamber’s 55 Democrats in rejecting Capriglione’s move.

The Republicans’ “nay” votes might provide fodder to a GOP primary challenger next year, GOP consultants said Thursday. The situation, though, was muddied by statements by the amendment’s author, Rep. Jeff Leach, R-Plano. He was reported as saying he didn’t need the House’s non-binding vote to instruct conferees, though he voted for it, because chief Senate negotiator Sen. Jane Nelson, R-Flower Mound, is working to improve his language.

Reps. Dawnna Dukes, D-Austin, and John Zerwas, R-Richmond, have said Leach’s language could have unintended consequences.

They describe Medicaid, a health insurance program for the poor, as constantly changing because federal and state officials dicker over program revisions proposed by states and new rules proposed by the feds. Dukes and Zerwas, both House budget writers, have warned that Leach’s amendment might inflict collateral damage on efforts under way to redirect special Medicaid payments for hospitals to new locally run experiments in Texas. Some of the new regional health partnerships could use the money to expand who is covered or what services are provided, such as mental health treatments.

President Lyndon B. Johnson, left, with former President Harry S. Truman at his side, signs into law on July 30, 1965, a bill creating Medicare for people age 65 and older and Medicaid for the poor

Rep. Lois Kolkhorst is riding point for the red team that is trying to keep Texas from doing the Medicaid expansion under Obamacare.

It’s a delicate role, which is perhaps why the Brenham Republican tried to wrap herself in Texas tradition in a final interview I did with her Friday morning for a story in Sunday’s paper about how the clash over Medicaid expansion is coming down to two competing philosophies — hers and Houston Democratic Rep. Garnet Coleman’s.

“Slow approaches are always better,” Kolkhorst said. “Texas has never jumped into any federal program. We have declined to take the Race to the Top money [for] our school districts, we made that decision. We didn’t jump into CHIP first and we didn’t jump into Medicaid back in the ’60s first. We’ve always taken the slow approach and it seemingly has led to a place where we’re the state that leads the economy right now in the nation.”

AP Photo/Austin American-Statesman, Rodolfo Gonzalez

Rep. Lois Kolkhorst at her 2011 swearing in, with son Jake, then 8

Is the part about always taking the slow approach true, I wondered.

Memories are pretty sharp about the U.S. Department of Education’s “Race to the Top” program, a $4.35 billion competitive fund that awarded grants to states to improve public schools. The money was part of President Barack Obama’s economic stimulus law. In January 2010, Gov. Rick Perry announced Texas would not compete for up to $700 million, saying the program “smacks of a federal takeover of our public schools.”

More problemmatic, though, is Kolkhorst’s suggestion that Texas dragged its feet in participating in the Children’s Health Insurance Program, created by Congress in a 1997 budget-balancing law, and Medicaid. Medicaid was created in 1965 when a Texan president, Lyndon B. Johnson, signed into law a bill creating both the state-federal program for the poor by that name, and the federally administered Medicare program for seniors.

In both cases, the health programs were created in bills signed by Democratic presidents — Bill Clinton and LBJ — in the summer right after a regular session of the Texas Legislature had just been concluded.

AP Photo/Harry Cabluck

Gov. George W. Bush, right, talks with journalists at the conclusion of an interview on Tuesday, June 3, 1997, in Austin, Texas. Bush said that if he runs for re-election, it will be for two compelling reasons; to continue work on education and welfare reform.

True, Texas sprinted into neither of the new health insurance programs. The sitting governor of Texas in 1965 was Democrat John Connally; and in 1997, Republican George W. Bush. Neither one called a special session to pass a bill rushing the launch of the heavily federally funded, state-managed program here. Bush received some pressure to move quickly to launch Texas CHIP, which wound up using private insurance to cover children of the working poor. He resisted. A check of library books about Connally and calls to a few Connally aides and watchers yielded no evidence he got strong prodding to speed up the kickoff of Texas Medicaid.

But in the regular sequence of state government decision-making, both programs were authorized by the Legislature at its next regular session. With biennial sessions, Texas often takes a couple of years to react to new federal laws. That’s what happened with Medicaid, which was passed by the Lege in the ’67 session and commenced in September of that year. And it happened with CHIP, which was passed in the ’99 session and signed by Bush. It launched in April 2000.

On Medicaid, Texas was a sprinter compared with Arizona. It became the last state to create a Medicaid program in 1982, 17 years after Johnson — with Connally part of his entourage — flew to Independence, Mo., to sign the law amending Social Security in the presence of former President Harry S. Truman, who had fought for national health insurance. Johnson adviser Wilbur Cohen had warned that the American Medical Association, the country’s main doctor group, would be upset because it had fought Truman tooth and nail over his proposal. Johnson ignored Cohen’s suggestion he sign the law at Hyde Park, N.Y., the home of Social Security’s creator, former President Franklin D. Roosevelt.

If Connally dragged his feet, it’s escaped mention in his memoirs and couple of biographies I perused Saturday.

Terrell Blodgett of Austin, a former policy adviser to Connally when he was governor, was stumped by my question.

“You got me,” Blodgett said. “I certainly don’t recall that we tried to delay it or anything but I couldn’t swear to it.”

Texas should skedaddle from Medicaid as soon as Congress will permit it to, and refashion the program using private health insurance, health savings accounts and stiff penalties for misusing hospital emergency rooms, according to an Austin-based think tank that wants less government.

The Texas Public Policy Foundation, which has close ties to Gov. Rick Perry and includes the former lawmaker who wrote the 2003 plan for cutting and overhauling state social services, issued its most detailed proposal yet for a Medicaid block grant on Wednesday.

“States cannot continue to survive … with the current program,” former Rep. Arlene Wohlgemuth, the foundation’s executive director and health policy point person, said in a conference call with reporters.

The report, drafted with the participation of national health-care policy expert James Capretta, suggests that Texas ask Congress to pass a law pulling Texas out of Medicaid and giving it a capped amount of federal funds. The federal government’s annual contribution would be linked to medical inflation and changes in the number of Texans below the federal poverty level.

AUSTIN — A sea of pink moved in and out of the Capitol halls today as Planned Parenthood advocates visited legislator offices.

Kicking off the day, a crowd of about 300 gathered in front of the statehouse to listen to senators and representatives before meeting with some lawmakers who weren’t necessarily on the same page, but were welcoming.

Supporters of Planned Parenthood, including one woman dressed as a pack of birth control pills, rally outside the Capitol on Thursday.

“One of our primary goals is to help educate legislators about preventative health services, and that’s why it’s so important for women to be there and share their stories,” said Danielle Wells, spokeswoman for Planned Parenthood of Greater Texas.

State Republican leaders want the group excluded because its affiliates provide abortions in separate, privately funded facilities.

The Texas Alliance for life, which will hold its own lobby day on March 20, says its goal is for the state to continue to not fund Planned Parenthood with family planning money and prevent them from being a provider for sexual education in Texas schools.

“There are ample alternative providers of family planning services to women and typically they offer comprehensive primary care, like prenatal care, which is a standard Planned Parenthood is unable to meet,” said Joe Pojman, executive director of Texas Alliance for Life.

Gov. Rick Perry has thrown his support behind anti-abortion bills like the identical House and Senate bill filed this week that would ban the procedure after 20 weeks under the theory that a fetus can experience pain.

The Legislature has targeted Planned Parenthood during the 2011 session, which banned affiliates of abortion providers from participating in the state women’s health program. The Texas Women’s Health Program took over for the federal Medicaid program after the government withdrew monetary support because of the affiliate ban, which was upheld in court. The federal government previously paid for 90 percent of the cost of the program, which provides care for low-income women. That cost will now be absorbed by the state.

Many of the Planned Parenthood rally-goers spoke about having trouble trusting the new state program after an online database of approved providers was found to have hundreds of inaccuracies, such as listing businesses unaffiliated with health care or clinics that were not enrolled in the program.

Alexis Lohse, a 32-year-old mother and Texas Christian University student, said when she called providers on the list she had a hard time finding a physician’s office with any openings in their schedule.

Lohse said she hopes the state will refund the provider and allow it back into the Texas Women’s Health Program.Continue reading →